Healthcare Provider Details

I. General information

NPI: 1316422090
Provider Name (Legal Business Name): LEIGHANNA LOUISE JAGELS ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2018
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1695 JEFFERSON ST
EUGENE OR
97402-4063
US

IV. Provider business mailing address

1695 JEFFERSON ST
EUGENE OR
97402-4063
US

V. Phone/Fax

Practice location:
  • Phone: 541-236-2910
  • Fax: 541-255-0943
Mailing address:
  • Phone: 541-236-2910
  • Fax: 541-255-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number4184
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: